Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a no...Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a non-randomized prospective observational cohort study. Inclusion of the study was done at the University Hospital, Uppsala, Sweden, between 2002 and 2007. Thirty-nine consecutive female patients admitted for anal sphincter repair were invited to the study. Twenty patients accepted and were included, four were lost to follow up and one was unevaluable (due to the formation of a stoma) leaving a study group of 15 patients. The patients were assessed with questionnaires before surgery and at three and 12 months after surgery. Outcomes: Change in reported sexual activity and dyspareunia. Results: Before surgery, 12/15 patients reported that their sexual life was impaired due to anal incontinence. The corresponding figure at 12 months was 9/15 (p = 0.43). Three patients remained sexually inactive throughout the study, five patients increased their sexual activity and one had decreased activity. Out of the 12 who were active, four stated dyspareunia at baseline, and only one reported dyspareunia at 12 months. The mean Miller incontinence scores at baseline and 12 months were 10.1 and 8.7, respectively. The change in incontinence score did not differ between those with decreased, stable or increased sexual activity. However, there was a definite correlation (r = 0.54 - 0.60, p 0.05) between change in sexual function and deferring time for stool. Clinical Implications: Operative management of anal sphincter tears alone is not curative for sexual problems due to anal incontinence but can be a part of the treatment. Strengths and Limitations: The study is a prospective study of sexual function. The limitations are that the questionnaires were not validated due to lack of such questionnaires at the time of the study and that the study population is quite small. Conclusion: Patients with a sphincter injury and fec展开更多
目的系统评价分娩时肛门括约肌损伤产妇的真实体验,为制订针对性护理措施提供参考。方法计算机检索PubMed、Embase、Web of Science、Medline、中国知网、万方、维普等中英文数据库,检索关于分娩时肛门括约肌损伤产妇真实体验和心理感...目的系统评价分娩时肛门括约肌损伤产妇的真实体验,为制订针对性护理措施提供参考。方法计算机检索PubMed、Embase、Web of Science、Medline、中国知网、万方、维普等中英文数据库,检索关于分娩时肛门括约肌损伤产妇真实体验和心理感受的质性研究,检索时限为建库至2022年1月。依据2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,利用汇集性整合法进行结果整合。结果共纳入10篇研究,提炼出91研究结果,将相似结果归纳形成8个新类别,最终得出4个整合结果:对日常生活的影响,对身心方面的影响,产妇缺乏医疗支持与互动,积极恢复、继续生活。结论护理人员应关注和了解分娩时肛门括约肌损伤产妇的真实体验,识别肛门括约肌损伤高危因素,给予针对性干预措施,同时建立多学科产后随访团队,协助产妇更好地重返社会,提高生活质量。展开更多
文摘Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a non-randomized prospective observational cohort study. Inclusion of the study was done at the University Hospital, Uppsala, Sweden, between 2002 and 2007. Thirty-nine consecutive female patients admitted for anal sphincter repair were invited to the study. Twenty patients accepted and were included, four were lost to follow up and one was unevaluable (due to the formation of a stoma) leaving a study group of 15 patients. The patients were assessed with questionnaires before surgery and at three and 12 months after surgery. Outcomes: Change in reported sexual activity and dyspareunia. Results: Before surgery, 12/15 patients reported that their sexual life was impaired due to anal incontinence. The corresponding figure at 12 months was 9/15 (p = 0.43). Three patients remained sexually inactive throughout the study, five patients increased their sexual activity and one had decreased activity. Out of the 12 who were active, four stated dyspareunia at baseline, and only one reported dyspareunia at 12 months. The mean Miller incontinence scores at baseline and 12 months were 10.1 and 8.7, respectively. The change in incontinence score did not differ between those with decreased, stable or increased sexual activity. However, there was a definite correlation (r = 0.54 - 0.60, p 0.05) between change in sexual function and deferring time for stool. Clinical Implications: Operative management of anal sphincter tears alone is not curative for sexual problems due to anal incontinence but can be a part of the treatment. Strengths and Limitations: The study is a prospective study of sexual function. The limitations are that the questionnaires were not validated due to lack of such questionnaires at the time of the study and that the study population is quite small. Conclusion: Patients with a sphincter injury and fec
文摘目的系统评价分娩时肛门括约肌损伤产妇的真实体验,为制订针对性护理措施提供参考。方法计算机检索PubMed、Embase、Web of Science、Medline、中国知网、万方、维普等中英文数据库,检索关于分娩时肛门括约肌损伤产妇真实体验和心理感受的质性研究,检索时限为建库至2022年1月。依据2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,利用汇集性整合法进行结果整合。结果共纳入10篇研究,提炼出91研究结果,将相似结果归纳形成8个新类别,最终得出4个整合结果:对日常生活的影响,对身心方面的影响,产妇缺乏医疗支持与互动,积极恢复、继续生活。结论护理人员应关注和了解分娩时肛门括约肌损伤产妇的真实体验,识别肛门括约肌损伤高危因素,给予针对性干预措施,同时建立多学科产后随访团队,协助产妇更好地重返社会,提高生活质量。
